Almanac of Clinical MedicineAlmanac of Clinical MedicineАльманах клинической медицины2072-05052587-9294Moscow Regional Research and Clinical Institute (MONIKI)177210.18786/2072-0505-2022-50-060ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИResearch ArticleThe impact of obesity on COVID-19 outcomes in hospitalized patientsВлияние ожирения на исходы COVID-19 у госпитализированных пациентовhttps://orcid.org/0000-0001-7911-24245914-2890MarkovaTatiana N.МарковаТатьяна Николаевна
Russian Federation

MD, PhD, Associate Professor; Professor, Chair of Endocrinology and Diabetology, Faculty of General Medicine; Head of Department of Endocrinology

д-р мед. наук, доцент, профессор кафедры эндокринологии и диабетологии лечебного факультета, заведующая отделением эндокринологии

markovatn18@yandex.ruhttps://orcid.org/0000-0002-6202-88215252-8148AnchutinaAnastasia A.АнчутинаАнастасия Алексеевна
Russian Federation

Senior Technician, Chair of Endocrinology and Diabetology, Faculty of General Medicine; Endocrinologist, Department of Endocrinology

старший лаборант кафедры эндокринологии и диабетологии лечебного факультета, врач-эндокринолог отделения эндокринологии

anastasia.ponomariova@yandex.ruhttps://orcid.org/0000-0003-3423-7893BodranetsAngelina A.БодранецАнгелина Александровна
Russian Federation

Resident Physician, Chair of Endocrinology and Diabetology, Faculty of General Medicine

клинический ординатор кафедры эндокринологии и диабетологии лечебного факультета

angelishka95@gmail.comA.I. Yevdokimov Moscow State University of Medicine and DentistryФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава РоссииMoscow City Clinical Hospital No. 52ГБУЗ г. Москвы «Городская клиническая больница № 52 ДЗМ»231220225084714801812202203022023Copyright ©; 2022, Markova T.N., Anchutina A.A., Bodranets A.A.Copyright ©; 2022, Маркова Т.Н., Анчутина А.А., Бодранец А.А.2022Markova T.N., Anchutina A.A., Bodranets A.A.Маркова Т.Н., Анчутина А.А., Бодранец А.А.https://creativecommons.org/licenses/by-nc/4.0https://almclinmed.ru/jour/article/view/1772

Background: Obesity is recognized as a risk factor for adverse outcomes in patients with COVID-19. However, a number of studies, including an analysis of the Federal Registry of Diabetic Patients (Russian Federation), have not identified any significant effect of obesity on mortality in COVID-19. Therefore, the role of obesity, assessed by body mass index (BMI) and waist circumference (WC), as a risk factor for an unfavorable course of coronavirus infection remains disputable.

Aim: To assess the impact of obesity on the severity and outcomes of coronavirus infection in the Russian population of hospitalized patients.

Materials and methods: This was a single center, retrospective, observational study in 367 patients with the polymerase chain reaction (PCR)-confirmed diagnosis of COVID-19 hospitalized to the in-patient department from April 2020 to November 2021. The first group included 185 patients with obesity (BMI ≥ 30.0 kg/m2); the second group consisted of 182 patients without obesity (BMI < 30.0 kg/m2). Prevalence of comorbidities, clinical and laboratory parameters, and computed tomography results were assessed in both groups. WC was measured in 100 patients.

Results: In this Russian population of hospitalized patients with COVID-19, obesity (BMI ≥ 30.0 kg/m2) didn't increase the probability of death both in the general sample (odds ratio (OR) = 1.31; 95% confidence interval (CI) 0.90–1.92, p = 0.164) and in the patients with type 2 diabetes (OR = 1.0; 95% CI 0.59–1.7, p = 0.997) or without diabetes (OR = 1.3; 95% CI 0.71–2.39, p = 0.392). However, obesity was associated with a 1,7-fold increase of the risk of severe COVID-19 (95% CI 1.13–2.59, p = 0.010). Morbid and abdominal obesity (according to World Health Organization and International Diabetes Federation criteria) had no significant impact on the death rate. WC of ≥ 101 cm, regardless of the patient’s gender, was associated with a 4,9-fold increase of the risk of death (95% CI 1.45–16.42, p = 0.012).

Conclusion: Obesity didn’t show any significant effect on mortality, but increased the chance of severe course of COVID-19 infection. Abdominal obesity (WC ≥ 101 cm) was a more significant factor in predicting of a fatal outcome, than BMI.

Актуальность. Ожирение считается фактором риска неблагоприятных исходов у больных COVID-19. Однако в ряде исследований, включая анализ Федерального регистра больных сахарным диабетом (Российская Федерация), не было установлено статистически значимого влияния ожирения на летальный исход при COVID-19. Вопрос о роли ожирения, рассчитанного по индексу массы тела (ИМТ) и окружности талии (ОТ), как фактора риска неблагоприятного течения коронавирусной инфекции остается дискутабельным.

Цель – оценить влияние ожирения на тяжесть течения и исходы коронавирусной инфекции в российской популяции госпитализированных больных.

Материал и методы. В рамках одноцентрового наблюдательного ретроспективного исследования проанализированы данные 367 пациентов с диагнозом COVID-19 (подтвержден методом полимеразной цепной реакции), госпитализированных в стационар в период с апреля 2020 по ноябрь 2021 г. Первую группу составили 185 больных, имеющих ожирение (ИМТ (кг/м2) ≥ 30), вторую – 182 пациента без ожирения (ИМТ < 30). Оценивали распространенность сопутствующих заболеваний, клинико-лабораторные показатели, результаты компьютерной томографии. Дополнительно проводилось определение ОТ (n = 100).

Результаты. В российской популяции госпитализированных пациентов с COVID-19 ожирение (ИМТ ≥ 30) не влияло на повышение шанса смертельного исхода как в общей выборке (отношение шансов (ОШ) 1,31; 95% доверительный интервал (ДИ) 0,90–1,92, p = 0,164), так и у пациентов с сахарным диабетом 2-го типа (ОШ 1,0; 95% ДИ 0,59–1,7, p = 0,997) и без диабета (ОШ 1,3; 95% ДИ 0,71–2,39, p = 0,392), но увеличивало шанс тяжелого течения COVID-19 в 1,7 раза (95% ДИ 1,13–2,59, p = 0,010). Наличие морбидного и абдоминального ожирения по критериям Всемирной организации здравоохранения и Международной федерации диабета незначимо влияло на смертельный исход. Показатель ОТ ≥ 101 см вне зависимости от пола повышал шанс летального исхода в 4,9 раза (95% ДИ 1,45–16,42, p = 0,012).

Заключение. Ожирение не оказывало значимого влияния на смертность, но повышало шанс тяжелого течения COVID-19. Абдоминальное ожирение (ОТ ≥ 101 см) было более значимым фактором прогнозирования летального исхода, чем показатель ИМТ.

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